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Licensing details for: 79052

Name: KHOI BINH NGUYEN DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

408 S Beach Blvd Ste 104
ANAHEIM CA 92804-1872
ORANGE county
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Practice Location

408 S Beach Blvd Ste 104
ANAHEIM CA 92804-1872
ORANGE county
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Issuance Date

July 20, 2016

Expiration Date

August 31, 2020

Current Date / Time

June 6, 2025
8:44:24 PM

License Relationships

AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: NGUYEN, KHOI BINH

License/Registration Type: Dentist License

License Number: 48754 Primary Status: Current - Active

Address :
17602 17th St
Unit 105
TUSTIN CA 92780-1961
ORANGE COUNTY

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